Individual provider Active NPI

Peter Michael Vandermeid, M.D.

  • Family Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1912959768
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101058587 Issued in VA
Practice address
1605 General Booth Blvd
Virginia Beach, VA 23454-5691
Phone
(757) 721-0512
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101058587 VA Primary

Addresses

Primary practice location

1605 General Booth Blvd
Virginia Beach, VA 23454-5691

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 822-4355

Other practice location 1

11803 Jefferson Ave Ste 125
Newport News, VA 23606-2565
Phone (757) 594-1990

Other identifiers 1

IdentifierTypeStateIssuer
010105897MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041214000304 VA Practitioner - Family Practice 2163489980 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Rappahannock Family Healthcare, Inc Family Medicine Past Accepting new patients
Windber Hospital, Inc. Past Accepting new patients
Medidoctors Primary Care LLC Family Medicine Past Accepting new patients
Sentara Hospitals Past Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1912959768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-822-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 GENERAL BOOTH BLVD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234545691",
            "telephone_number": "757-721-0512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11803 Jefferson Ave Ste 125",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236062565",
            "country_code": "US",
            "telephone_number": "757-594-1990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERMEID",
        "first_name": "PETER",
        "middle_name": "MICHAEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101058587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010105897",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

Verify at the official NPI Registry.